Metabolomic Fingerprints of Medical Therapy Versus Bariatric Surgery in Patients With Obesity and Type 2 Diabetes: The STAMPEDE Trial
Authors' conclusion
We identified a novel metabolomic fingerprint characterizing the longer-term adaptations to MT, RYGB, and SG. Notably, the metabolomic profiles of RYGB and SG procedures were distinct, indicating equivalent weight loss may be achieved by divergent effects on metabolism.
Study context
- Population
- Patients with obesity and T2D; age 49.9 ± 7.6 years; 57.7% female
- Participants
- 90 patients
- Comparison
- Medical therapy (MT) vs RYGB vs sleeve gastrectomy (SG)
- MTn = 30reference
- RYGBn = 30
- SGn = 30
- Primary endpoint
- Metabolic signatures associated with biochemical resolution of T2D (plasma untargeted metabolomics)
- Follow-up
- Baseline and 24 months
Methodological detailsretrospective untargeted metabolomic analysis, supervised machine learning (random forest), linear mixed effects model
- Retrospective untargeted metabolomic analysis
- Supervised machine learning (random forest)
- Linear mixed effects model
Primary result
As reported in the abstract
Circulating metabolome · 24 months
- Metabolome dramatically remodeled after SG and RYGB, with largely overlapping signatures after MT
- Vs MT, SG and RYGB profoundly enhanced metabolites of lipid and amino acid signaling, while limiting xenobiotic metabolites (decreased medication use)
- Random forest: 2-hydroxydecanoate selectively important to RYGB and most distinguishing feature between MT, SG and RYGB
- Change in 2-hydroxydecanoate correlated with reductions in fasting glucose after RYGB but not SG or MT
Original publication
Metabolomic Fingerprints of Medical Therapy Versus Bariatric Surgery in Patients With Obesity and Type 2 Diabetes: The STAMPEDE Trial. Diabetes Care. Published 23 September 2024. doi:10.
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